生物补片盆底修补术和直接缝合术在低位直肠癌患者盆底重建中的应用研究  

Application of biological patch pelvic floor repair and direct suture in pelvic floor reconstruction of patients with low rectal cancer

作　　者：薛昶 王翔 冯利 金鑫 王治伟 Xue Chang;Wang Xiang;Feng Li;Jin Xin;Wang Zhiwei(Department of Anorectal,Ankang Central Hospital,Ankang Shaanxi Province 725000,China;Department of Gastroenterology,Ankang Central Hospital,Ankang Shaanxi Province 725000,China)

机构地区：[1]安康市中心医院肛肠科,陕西安康725000 [2]安康市中心医院胃肠外科,陕西安康725000

出　　处：《中华普外科手术学杂志（电子版）》2024年第3期327-329,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：陕西省重点研发计划项目(2018SF-284)。

摘　　要：目的探究生物补片盆底修补术和直接缝合术在低位直肠癌患者盆底重建中的作用。方法回顾性分析我院2020年6月至2023年6月就诊的90例低位直肠癌患者的临床资料,所有患者均接受腹腔镜下会阴联合直肠癌根治术(ARP),依据术中盆底重建方式分为生物补片组(n=45)和直接缝合组(n=45)。利用SPSS 22.0统计学软件进行数据分析,术中情况、最大排尿量、最大尿流速等计量资料用(x±s)表示,行独立样本t检验;术后并发症等计数资料用[例(%)]表示,行χ^(2)检验。P<0.05表示有统计学差异。结果生物补片组患者术中出血量少于直接缝合组,拔管时间、会阴拆线时间均显著短于直接缝合组(P<0.05),手术时间、住院时间、术后平均最大排尿量比较差异无统计学意义(P>0.05)。生物补片组患者术后并发症总发生率显著低于直接缝合组,最大尿流速高于直接缝合组(P<0.05)。结论与直接缝合盆底修复相比,ARP后采用生物补片修复盆底对低位直肠癌患者创口愈合、并发症预防效果更佳。Objective To explore the role of biological patch pelvic floor repair and direct suture in pelvic floor reconstruction in patients with low rectal cancer.Methods Ninety patients with low rectal cancer treated in our hospital from June 2020 to June 2023 were selected as the study objects.All patients received laparoscopic perineal combined radical resection of rectal cancer(ARP),and were divided into biological mesh group(n=45)and direct suture group(n=45)according to intraoperative pelvic floor reconstruction methods.SPSS 22.0 was used for data analysis.Intraoperative conditions,maximum urine output,maximum urine flow rate and other measurement data were expressed as(x±s),and independent sample t test was performed.The statistical data of postoperative complications were expressed by[cases(%)]andχ^(2)test was performed.P<0.05 indicates statistical difference.Results The amount of intraoperative blood loss in the biological patch group was less than that in the direct suture group,and the time of extubation and perineal suture removal were significantly shorter than that in the direct suture group(P<0.05).There was no significant difference in the operative time,hospital stay and postoperative mean maximum urine volume(P>0.05).The incidence of postoperative complications in biological mesh group was significantly lower than that in direct suture group,and the maximum urinary flow velocity was higher than that in direct suture group(P<0.05).Conclusion Compared with direct suture pelvic floor repair,the application of biological patch after ARP is more effective in wound healing and complication prevention in patients with low rectal cancer.

关 键 词：直肠肿瘤 盆底修补 生物补片 缝合技术 

分 类 号：R735.37[医药卫生—肿瘤]